Development of a Tobacco Control Prescription in a Southern US City.

The Problem: Nationwide efforts to reduce smoking in the United States have been successful. Yet, there is unequal geographic progress in reducing rates of smoking and smoking-related illnesses. Located in a tobacco-producing state with weak tobacco laws, Nashville, Tennessee, has an adult smoking rate of 22.

Regulation of lipolysis and lipoprotein lipase after weight loss in obese, postmenopausal women.

Objective: To test the hypothesis that the greater beta-adrenoceptor (beta-AR)-stimulated lipolysis and sensitivity (half-maximal lipolytic response) in abdominal (ABD) adipocytes, greater gluteal (GLT) adipose tissue-lipoprotein lipase (AT-LPL) activity, and dyslipidemia associated with obesity in older women are modifiable by weight loss (WL) and are not due to menopause or aging.

Research Methods And Procedures: The metabolic effects of 6 months of hypocaloric diet and low-intensity walking WL program on the regional regulation of in vitro lipolysis and AT-LPL activity in subcutaneous ABD and GLT adipocytes were measured in 34 obese (48.7 +/- 0.

Responses of adipose tissue lipoprotein lipase to weight loss affect lipid levels and weight regain in women.

This study determines whether changes in abdominal (ABD) and gluteal (GLT) adipose tissue lipoprotein lipase (LPL) activity in response to a 6-mo weight loss intervention, comprised of a hypocaloric diet and low-intensity walking, affect changes in body composition, fat distribution, lipid metabolism, and the magnitude of weight regain in 36 obese postmenopausal women. Average adipose tissue LPL activity did not change with an average 5.6-kg weight loss, but changes in LPL activity were inversely related to baseline LPL activity (ABD: r = -0.

Aerobic exercise training-induced reductions in abdominal fat and glucose-stimulated insulin responses in middle-aged and older men.

Objective: To test the effects of aerobic exercise training on glucose-stimulated insulin responses in middle-aged and older individuals.

Design: A 9-month moderate-intensity aerobic exercise training trial in 17 men.

Setting: An academic medical center.

Lipoprotein lipase gene variation is associated with adipose tissue lipoprotein lipase activity, and lipoprotein lipid and glucose concentrations in overweight postmenopausal women.

Adipose tissue lipoprotein lipase (LPL) activity is under strong genetic control in both mice and humans. This study determines whether common DNA variation in the LPL gene (PvuII and HindIII polymorphisms) is associated with adipose tissue LPL activity and metabolic risk factors in a homogeneous population of 75 overweight postmenopausal women (body mass index >25 kg/m2; age: 51-69 years old). The allele frequencies for the presence of the cut-sites for LPL HindIII and PvuII were 0.

Predictors of adipose tissue lipoprotein lipase in middle-aged and older men: relationship to leptin and obesity, but not cardiovascular fitness.

The effects of long-term endurance exercise training, body composition, and cardiovascular fitness (VO2max) on the activity of adipose tissue lipoprotein lipase (AT-LPL) and lipoprotein lipids were examined in 66 healthy age-matched middle-aged and older men (mean +/- SE, 61 +/- 1 years). We compared subcutaneous abdominal (ABD) and gluteal (GLT) heparin-elutable AT-LPL activity in 19 master athletes (VO2max > 40 mL/kg/min) and 20 lean sedentary men (VO2max < 40 mL/kg/min) versus 27 obese sedentary men (VO2max < 40 mL/kg/min; body fat > 27%). Fasting insulin and leptin levels were similar in master athletes and lean sedentary men, but were lower than in obese sedentary men.

Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men.

The clustering of metabolic abnormalities often associated with hypertension, including insulin resistance, glucose intolerance, and dyslipidemia, in middle-aged men may be the result of a decrease in cardiovascular fitness (VO2max) and the accumulation of body fat with aging. This study examines the effects of a 6-month program of aerobic exercise training plus weight loss (AEX+WL) on VO2max, body composition, blood pressure (BP), glucose and insulin responses during an oral glucose tolerance test (OGTT), glucose infusion rates (GIR) during 3-dose hyperinsulinemic-euglycemic clamps at insulin infusion rates of 120, 600, and 3,000 pmol x m(-2) x min(-1), and plasma lipoprotein levels. Compared with eight non-obese, normotensive, sedentary men (age, 62+/-2 years; 19%+/-2% fat; BP, 117+/-4/72+/-2 mm Hg), the nine obese, hypersensitive, sedentary men studied (age, 56+/-1 year; 32%+/-1% body fat; BP, 147+/-3/93+/-2 mm Hg) initially had a larger waist girth and waist-to-hip ratio (WHR) and were more hyperinsulinemic and insulin resistant with lower GIR at the two lower insulin infusion rates of the clamp and had a 2.

Regional differences in adrenoceptor binding and fat cell lipolysis in obese, postmenopausal women.

In women there is an increase in visceral obesity, subcutaneous abdominal adipocyte lipolysis, and risk of cardiovascular disease (CVD) associated with weight gain after menopause. The mechanisms underlying this increase in adrenoreceptor (AR)-agonist catecholamine-stimulated lipolysis and abdominal obesity in postmenopausal women were studied in intact adipocytes isolated from the abdominal and gluteal subcutaneous fat depots in 19 obese (48% +/- 1% body fat, mean +/- SE) women with a mean +/- SE age of 58 +/- 1 years. The fat cell size and adipose tissue lipoprotein lipase (ATLPL) activity were similar in both sites.

Sequential effects of aerobic exercise training and weight loss on risk factors for coronary disease in healthy, obese middle-aged and older men.

The relative benefits of weight loss (WL) versus aerobic exercise training (AEX) on cardiac risk factors in obese individuals remain controversial. In this study, we examined the effects of the sequential interventions of 9 months of AEX followed by weight loss with continued AEX (AEX + WL) on cardiac risk factors in 21 obese (body fat, 29.5% +/- 0.

Exercise blunts declines in lipolysis and fat oxidation after dietary-induced weight loss in obese older women.

Weight loss (WL) by hypocaloric diet decreases adipocyte lipolysis and fat oxidation, adaptations that might predispose individuals to regain weight. Our hypothesis was that the addition of endurance exercise (EX) to dietary-induced WL (6 mo; 250-350 kcal/day deficit) would prevent declines in abdominal (ABD) and gluteal (GLT) adipocyte lipolysis and fat oxidation in obese older women. At baseline, the WL (n = 9) and WL+EX (n = 11) groups had similar body composition, fat distribution, aerobic fitness (VO2max), and resting fat metabolism.

Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men.

The decline in glucose homeostasis with aging may be due to the physical deconditioning and obesity that often develop with aging. The independent and combined effects of aerobic exercise training (AEX) and weight loss (WL) on glucose metabolism were studied in 47 nondiabetic sedentary older men. There were 14 men in a weekly behavioral modification/WL program, 10 in a 3 times/wk AEX program, 14 in an AEX+WL program, and 9 in the control (Con) group.

Visceral adiposity, increased adipocyte lipolysis, and metabolic dysfunction in obese postmenopausal women.

This study determines whether there are regional differences in lipolysis and whether adipocyte lipolysis is associated with the degree of visceral adiposity and its metabolic complications in 32 obese (28-37 kg/m2), nondiabetic, postmenopausal women. In vitro lipolysis was measured in the basal state and after addition of epinephrine (Epi), Epi plus yohimbine, Epi plus propranolol, and N6,2'-O-dibutyryl adenosine 3',5'-cyclic monophosphate (DBcAMP) in abdominal (ABD) and gluteal (GLT) adipocytes. Upper body obese [UBO, waist-to-hip ratio (WHR) > or = 0.

Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial.

Objective: To compare the effects of weight loss vs aerobic exercise training on coronary artery disease risk factors in healthy sedentary, obese, middle-aged and older men.

Design: Randomized controlled trial.

Subjects: A total of 170 obese (body mass index, 30 +/- 1 kg/m2 [mean +/- SEM]), middle-aged and older (61 +/- 1 years) men.

The role of obesity and cardiovascular fitness in the impaired glucose tolerance of aging.

The prevalence of impaired glucose tolerance (IGT) increases with aging. Although some data suggest that age is independently associated with IGT, other studies suggest that age-associated changes in body composition and reduced cardiovascular fitness are responsible for the development of IGT. We, therefore, examined the relationship of age, total and regional adiposity, and level of fitness (VO2max) to the presence of IGT in 155 healthy, nondiabetic, nonsmoking, older community dwelling men.

Weight loss reduces abdominal fat and improves insulin action in middle-aged and older men with impaired glucose tolerance.

Aging is associated with an increased accumulation of abdominal fat, glucose intolerance, and insulin resistance. We tested the hypothesis that diet-induced weight loss would reduce the abdominal distribution of fat and improve glucose tolerance and insulin action in a group of obese middle-aged and older men with normal or impaired glucose tolerance (IGT). Oral glucose tolerance tests (OGTTs) were performed at baseline and after 9 months of diet-induced weight loss in 35 men (mean age, 60 +/- 8 years).

Effects of weight loss on norepinephrine and insulin levels in obese older men.

Older individuals have higher plasma insulin and norepinephrine (NE) levels than the young. This may be due to biological aging; however, these changes also may be due in part to the increase in abdominal obesity that often accompanies aging. The latter possibility was tested by examining the effects of weight loss on plasma insulin and NE levels in 11 healthy men aged 52 to 72 years who had mild to moderate obesity (body mass index [BMI], 27 to 36 kg/m2).

Enhanced insulin sensitivity and lower waist-to-hip ratio in master athletes.

The effect of long-term aerobic exercise training on insulin action was determined in older individuals by comparing insulin sensitivity and maximal responsiveness in 11 master athletes [63.5 +/- 1.9 (SE) yr] and 10 age- and body fat-matched sedentary individuals.

Persistence of low HDL-C levels after weight reduction in older men with small LDL particles.

LDL subclass pattern B is characterized by a predominance of small LDL particles (LDL peak particle size < or = 255 A) and is associated with increased plasma triglyceride (TG) and reduced HDL cholesterol (HDL-C) concentrations. This study compared the effect of weight loss on lipoprotein and glucose metabolism in 15 healthy, obese (body mass index [BMI], 30.9 +/- 2.

Seven consecutive days of exercise lowers plasma insulin responses to an oral glucose challenge in sedentary elderly.

Objective: To assess the effects of 1 and 7 consecutive days of exercise on glucose and insulin responses to an oral glucose challenge.

Design: Intervention group assessed at baseline and after 1 and 7 days of exercise.

Setting: Academic medical institution.

Reduced adipose tissue lipoprotein lipase responses, postprandial lipemia, and low high-density lipoprotein-2 subspecies levels in older athletes with silent myocardial ischemia.

Healthy older (64 +/- 1 years, mean +/- SEM) athletic (maximal oxygen consumption [VO2max] > 40 mL/kg/min) normocholesterolemic men with no prior history of coronary artery disease (CAD) were recruited for cardiovascular and metabolic studies. Thirty-three percent had asymptomatic exercise-induced ST segment depression on their exercise electrocardiogram (ECG), consistent with silent myocardial ischemia (SI). We hypothesized that abnormalities in high-density lipoprotein (HDL) and postprandial triglyceride (TG) metabolism may increase their risk for CAD.

The effects of single and sequential insulin infusions on glucose disposal in older men.

The hyperinsulinemic euglycemic glucose clamp is widely used to quantitate in vivo insulin action. Modification of this technique by sequentially infusing multiple doses of insulin allows determination of insulin sensitivity and maximal responsiveness; however, the validity of this approach has not been determined in older individuals. In this study, glucose disposal rates during a sequential three-dose clamp at insulin infusion rates of 20, 100, and 500 mU/m2.

Role of body fat distribution in the decline in insulin sensitivity and glucose tolerance with age.

The relationships of body composition and physical fitness [maximal aerobic capacity (VO2max)] to the decline in insulin sensitivity with age were examined in healthy older (47-73 yr; n = 36) and young (19-36 yr; n = 13) men. In 18 older men with normal glucose tolerance (OGTT), glucose disposal rates (M) during hyperinsulinemic euglycemic clamps correlated negatively with the waist to hip ratio (WHR; r = -0.77; P < .

Time course of plasma free fatty acid concentration in response to insulin: effect of obesity and physical fitness.

This study examines the relationships between parameters of the time course of plasma free fatty acid (FFA) concentration during a euglycemic, hyperinsulinemic clamp (100 mU/m2.min) and the age, body composition, and physical fitness, indexed as maximal aerobic capacity (VO2 max), of three groups of healthy men: (A) 20 obese older men (32% +/- 1% fat, aged 60 +/- 2 years, mean +/- SEM); (B) 11 lean older men (19% +/- 1% fat, aged 63 +/- 2 years); and (C) 11 lean younger men (16% +/- 2% fat, aged 27 +/- 2 years). The time course was modeled as a delayed exponential decline from an initial level to a plateau level.

Effects of age and adenosine in the modulation of insulin action on rat adipocyte metabolism.

The age-related declines in the antilipolytic and lipogenic actions of insulin were studied in adipocytes from rats aged 2, 6, 12, and 24 months. Since adenosine modulates insulin action, its concentration was controlled by treatment of adipocytes with adenosine deaminase and addition of the non-metabolizable adenosine analog, N6-[(R)-(-)1-methyl-2-phenethyl] adenosine (PIA). Inhibition of isoproterenol-stimulated lipolysis by PIA increased significantly by 6 months of age.

Insulin depolarization of skeletal muscle in absence of external Na+.

Three mechanisms have been proposed by which insulin might increase the electrical potential difference across the cell membrane of some of its main target cells: stimulation of an electrogenic pump; increased permeability to K+ (PK); and decreased ratio of permeability to Na+ (PNa) compared to PK, with an absolute decrease in permeability to both ions. Our laboratory has reported that insulin-induced hyperpolarization (IIH) of rat skeletal muscle is not due to stimulation of a ouabain-inhibitable pump and that insulin decreases 42K efflux, apparently eliminating the first two candidate mechanisms. If the remaining hypothesis is correct, when Na+ is removed from the bathing solution, insulin should depolarize, not hyperpolarize.